Meconium-stained amniotic fluid as a predictor of poor outcomes in gastroschisis. J Pediatr Surg 2018 Sep;53(9):1665-1668
Date
05/29/2018Pubmed ID
29803305DOI
10.1016/j.jpedsurg.2018.04.023Scopus ID
2-s2.0-85047296681 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
OBJECTIVE: The aim of this study was to determine if meconium-stained amniotic fluid (MSAF) was associated with neonatal outcomes in gastroschisis.
STUDY DESIGN: A retrospective chart review of gastroschisis patients from 2000 to 2014 at a single, tertiary institution was performed. Statistical analysis was performed with Fisher exact test, Welch's t-test, logistic regression and/or linear regression with significance at p < 0.05.
RESULTS: Sixty-four of 135 (47.4%) gastroschisis patients had MSAF. On univariate analysis, patients with MSAF were more likely to require staged closure (30 (46.9%) vs. 18(25.4%), p = 0.012), had more ventilator days (8.9 ± 11.1 vs. 5.3 ± 6.3, p = 0.021) and longer times to commence enteral feeds (24.9 ± 21.7 vs. 18.5 ± 14.5, p = 0.045). However, multi-variate regression analysis controlling for the type of closure, showed that delayed closure, but not MSAF, was associated with worse outcomes.
CONCLUSIONS: In gastroschisis patients, MSAF is associated with delayed closure but is not associated with outcomes independent of closure type. This association may be because of the matting of the bowel or increased intestinal damage. The MSAF status will aid in setting expectations for parents during their initial NICU stay and further investigation is warranted.
TYPE OF STUDY: Clinical Research Paper Level of evidence: III.
Author List
Koehler SM, Loichinger M, Peterson E, Christensen M, Szabo A, Wagner AJAuthors
Erika Peterson MD Professor in the Obstetrics and Gynecology department at Medical College of WisconsinAniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Amy Wagner MD Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Amniotic FluidFemale
Gastroschisis
Humans
Infant, Newborn
Linear Models
Logistic Models
Male
Meconium
Prognosis
Retrospective Studies